The Sol Goldman Pancreatic Cancer Research Center

Blood Tests

Physicians usually perform a variety of blood tests on patients suspected of having pancreatic cancer. We would like to emphasize three of them.

CA 19-9
CA19-9 is a tumor marker for pancreas cancer that is measured with a blood test. CA 19-9 levels can assist with an initial diagnosis. However, CA 19-9 levels are more useful in measuring the response of a cancer that has already been diagnosed to treatment. In general, a declining or stable CA19-9 level generally indicates that the tumor is responding to treatment, while increasing levels indicates the progression of disease.The old adage, "treat the patient not blood numbers," should be remembered. If a patient is feeling better and the tumor shrinks, that is what matters.

Blood glucose level
Pancreatic cancer is associated with abnormalities in blood glucose (sugar) levels. Long-standing diabetes mellitus (sugar diabetes) is a risk factor for developing pancreatic cancer, and recent onset diabetes in a person above the age of 50 years can be an early sign of pancreatic cancer. Patients with diabetes often have abnormally high blood glucose levels. Doctors may therefore draw blood from the patient's arm in order to measure their blood glucose levels. Abnormally high levels may suggest diabetes. Abnormally low levels can be seen in a variety of conditions, including the very rare neuroendocrine tumor of the pancreas called a "glucagonoma."

Blood bilirubin level
As discussed earlier in the anatomy section, the liver produces fluid called bile. Bile made in the liver collects in tubes (the bile ducts) in the liver. These bile ducts join together to form the common bile duct. The common bile duct drains into the duodenum where the bile assists in the digestion of food. At one point along its course, the common bile duct passes through the pancreas. Cancers arising in the pancreas can impinge upon the bile duct and block the flow of bile. This may produce a yellowing of the white portion of the eyes (called jaundice), and in some patients jaundice is the first presentation of their pancreatic cancer. Doctors may therefore draw blood from the patient to test it for "bilirubin" levels (one of the components of bile). High bilirubin levels, called hyperbilirubinemia, would suggest that there is something obstructing the normal flow of bile such as a tumor in the pancreas.